Overview

Population Characteristics

  • This dataset include 463 confirmed cases admitted from 2018-08-05 to 2019-07-15.

  • 56% women and 4% children ≤5 years.

  • 150 confirmed deaths reported for an average CFR of 32%.

Stratified Tables

Population characteristics: Children va Adults
Characteristic Adult
N = 3861		 Children (<18)
N = 621		 p-value2
Age at admission – – 0.00
    Median (Min, Max) 33 (18, 71) 10 (0, 17) –
Age Group – – 0.00
    <5 0 (0%) 18 (29%) –
    5-17 0 (0%) 44 (71%) –
    18-24 90 (23%) 0 (0%) –
    25-34 115 (30%) 0 (0%) –
    35-49 122 (32%) 0 (0%) –
    50+ 59 (15%) 0 (0%) –
Gender – – 0.75
    Male 166 (43%) 28 (45%) –
    Female 220 (57%) 34 (55%) –
Patient occupation – – 0.02
    Healthcare worker 45 (19%) 0 (0%) –
    Non-healthcare worker 111 (47%) 21 (68%) –
    Unknown 78 (33%) 10 (32%) –
Is the patient pregnant? 15 (3.9%) 1 (1.6%) 0.71
Admission Delay – – 0.62
    Median (Min, Max) 4.0 (0.0, 34.0) 4.0 (0.0, 39.0) –
Does the patient have any comorbid conditions? 8 (2.1%) 0 (0%) 0.61
Diabetes 1 (0.3%) 0 (0%) 1.00
HIV 3 (0.8%) 0 (0%) 1.00
Chronic pulmonary disease 1 (0.3%) 0 (0%) 1.00
Bleeding 33 (8.5%) 7 (11%) 0.48
Fever 197 (51%) 51 (82%) 0.00
Diarrhoea 142 (37%) 17 (27%) 0.15
Shock 2 (0.5%) 0 (0%) 1.00
Confusion 1 (0.3%) 0 (0%) 1.00
Ebola RDT – – 1.00
    Oraquick 4 (1.3%) 0 (0%) –
    Not done 313 (99%) 49 (100%) –
Result of GeneXpert PCR – – 0.36
    Positive 322 (99%) 50 (98%) –
    Negative 1 (0.3%) 1 (2.0%) –
    Indeterminate 1 (0.3%) 0 (0%) –
Ct (lowest) – – 0.30
    Median (Min, Max) 24 (15, 42) 23 (16, 40) –
Ct Below 23 124 (32%) 21 (34%) 0.78
Hypokaliemia 10 (2.6%) 1 (1.6%) 1.00
Hyperkaliemia 5 (1.3%) 2 (3.2%) 0.25
Renal impairment 41 (11%) 3 (4.8%) 0.16
Rhabdomyolysis 17 (4.4%) 2 (3.2%) 1.00
Severe hypoglycemia 6 (1.6%) 1 (1.6%) 1.00
Platelets (x10⁹/L) – – 0.41
    Median (Min, Max) 168 (27, 385) 106 (88, 164) –
Haemoglobin (g/L) – – 0.40
    Median (Min, Max) 13.30 (9.00, 17.90) 12.00 (10.60, 13.80) –
Calcium (mmol/L) US – – 0.57
    Median (Min, Max) 8.20 (4.00, 10.40) 8.50 (7.50, 9.70) –
Antibacterial treatment 326 (84%) 52 (84%) 0.91
Antimalarial treatment 285 (74%) 43 (69%) 0.46
Oral/orogastric fluids 64 (17%) 13 (21%) 0.40
Blood transfusion 1 (0.3%) 2 (3.2%) 0.05
Ebola experimental treatment at admission 170 (44%) 25 (40%) 0.58
Type of Ebola experimental treament at admission – – 0.37
    REGN3470-3471-3479 43 (11%) 4 (6.5%) –
    Remdesivir (GS-5734) 53 (14%) 5 (8.1%) –
    Zmapp 7 (1.8%) 1 (1.6%) –
    mAb114 64 (17%) 15 (24%) –
    None 219 (57%) 37 (60%) –
Ebola experimental treatment 306 (79%) 45 (73%) 0.23
Type of Ebola experimental treament – – 0.20
    REGN3470-3471-3479 93 (24%) 11 (18%) –
    Remdesivir (GS-5734) 113 (29%) 12 (19%) –
    Zmapp 22 (5.7%) 5 (8.1%) –
    mAb114 78 (20%) 17 (27%) –
    None 80 (21%) 17 (27%) –
Days from Treament Initiation – – 0.38
    Median (Min, Max) 4.0 (-361.0, 36.0) 5.0 (0.0, 32.0) –
Delay from Treament – – 0.36
    Less than 3 days 69 (23%) 11 (24%) –
    3 to 5 days 84 (28%) 8 (18%) –
    More than 5 days 150 (50%) 26 (58%) –
Outcome at discharge – – 0.48
    Death 126 (33%) 20 (32%) –
    Full recovery with sequelae 1 (0.3%) 0 (0%) –
    Full recovery without sequelae 216 (56%) 31 (50%) –
    Referred to another facility 2 (0.5%) 0 (0%) –
    Unknown 41 (11%) 11 (18%) –
1 n (%)
2 Wilcoxon rank sum test; Fisher’s exact test; Pearson’s Chi-squared test
Population characteristics by Outcome
Characteristic Deceased
N = 1501		 Recovered
N = 2581		 p-value2
Age at admission – – 0.87
    Median (Min, Max) 30 (3, 70) 32 (0, 71) –
Age Group – – 0.27
    <5 2 (1.4%) 11 (4.4%) –
    5-17 18 (12%) 20 (8.1%) –
    18-24 26 (18%) 53 (21%) –
    25-34 44 (30%) 60 (24%) –
    35-49 37 (25%) 71 (29%) –
    50+ 19 (13%) 33 (13%) –
Gender – – 0.69
    Male 67 (45%) 110 (43%) –
    Female 83 (55%) 148 (57%) –
Patient occupation – – 0.03
    Healthcare worker 9 (11%) 33 (23%) –
    Non-healthcare worker 38 (46%) 67 (47%) –
    Unknown 36 (43%) 43 (30%) –
Is the patient pregnant? 5 (3.3%) 11 (4.3%) 0.64
Admission Delay – – 0.00
    Median (Min, Max) 5.0 (0.0, 39.0) 3.0 (0.0, 32.0) –
Does the patient have any comorbid conditions? 4 (2.7%) 3 (1.2%) 0.27
Diabetes 1 (0.7%) 0 (0%) 0.37
HIV 2 (1.3%) 1 (0.4%) 0.56
Chronic pulmonary disease 0 (0%) 1 (0.4%) 1.00
Bleeding 22 (15%) 15 (5.8%) 0.00
Fever 88 (59%) 144 (56%) 0.57
Diarrhoea 70 (47%) 78 (30%) 0.00
Shock 2 (1.3%) 0 (0%) 0.13
Confusion 1 (0.7%) 0 (0%) 0.37
Ebola RDT – – 0.63
    Oraquick 2 (1.6%) 2 (0.9%) –
    Not done 126 (98%) 212 (99%) –
Result of GeneXpert PCR – – 0.71
    Positive 130 (100%) 212 (99%) –
    Negative 0 (0%) 2 (0.9%) –
    Indeterminate 0 (0%) 1 (0.5%) –
Ct (lowest) – – 0.00
    Median (Min, Max) 21 (13, 40) 29 (18, 42) –
Ct Below 23 93 (62%) 41 (16%) 0.00
Hypokaliemia 1 (0.7%) 9 (3.5%) 0.10
Hyperkaliemia 6 (4.0%) 2 (0.8%) 0.06
Renal impairment 20 (13%) 22 (8.5%) 0.12
Rhabdomyolysis 13 (8.7%) 6 (2.3%) 0.00
Severe hypoglycemia 4 (2.7%) 2 (0.8%) 0.20
Platelets (x10⁹/L) – – 0.56
    Median (Min, Max) 164 (30, 385) 142 (27, 385) –
Haemoglobin (g/L) – – 0.28
    Median (Min, Max) 13.80 (10.60, 17.90) 12.90 (9.00, 17.90) –
Calcium (mmol/L) US – – 0.00
    Median (Min, Max) 7.75 (4.00, 9.00) 8.70 (4.00, 10.40) –
Antibacterial treatment 136 (91%) 207 (80%) 0.01
Antimalarial treatment 119 (79%) 177 (69%) 0.02
Oral/orogastric fluids 21 (14%) 49 (19%) 0.20
Blood transfusion 4 (2.7%) 0 (0%) 0.02
Ebola experimental treatment at admission 72 (48%) 105 (41%) 0.15
Type of Ebola experimental treament at admission – – 0.00
    REGN3470-3471-3479 22 (15%) 27 (10%) –
    Remdesivir (GS-5734) 26 (17%) 22 (8.5%) –
    Zmapp 5 (3.3%) 1 (0.4%) –
    mAb114 18 (12%) 53 (21%) –
    None 79 (53%) 155 (60%) –
Ebola experimental treatment 122 (81%) 205 (79%) 0.65
Type of Ebola experimental treament – – 0.00
    REGN3470-3471-3479 33 (22%) 72 (28%) –
    Remdesivir (GS-5734) 55 (37%) 57 (22%) –
    Zmapp 11 (7.3%) 10 (3.9%) –
    mAb114 23 (15%) 66 (26%) –
    None 28 (19%) 53 (21%) –
Days from Treament Initiation – – 0.00
    Median (Min, Max) 5.0 (-4.0, 36.0) 4.0 (-361.0, 32.0) –
Delay from Treament – – 0.00
    Less than 3 days 14 (12%) 65 (32%) –
    3 to 5 days 34 (28%) 47 (23%) –
    More than 5 days 73 (60%) 91 (45%) –
1 n (%)
2 Wilcoxon rank sum test; Fisher’s exact test; Pearson’s Chi-squared test
Population characteristics by Sex
Characteristic Male
N = 2031		 Female
N = 2601		 p-value2
Age at admission – – 0.56
    Median (Min, Max) 32 (0, 71) 30 (0, 70) –
Age Group – – 0.06
    <5 9 (4.6%) 9 (3.5%) –
    5-17 19 (9.8%) 25 (9.8%) –
    18-24 30 (15%) 60 (24%) –
    25-34 55 (28%) 60 (24%) –
    35-49 62 (32%) 60 (24%) –
    50+ 19 (9.8%) 40 (16%) –
Patient occupation – – 0.17
    Healthcare worker 22 (18%) 23 (15%) –
    Non-healthcare worker 64 (54%) 71 (46%) –
    Unknown 33 (28%) 59 (39%) –
Is the patient pregnant? 0 (0%) 16 (6.2%) 0.00
Admission Delay – – 0.33
    Median (Min, Max) 4.0 (0.0, 28.0) 4.0 (0.0, 39.0) –
Does the patient have any comorbid conditions? 3 (1.5%) 5 (1.9%) 1.00
Diabetes 0 (0%) 1 (0.4%) 1.00
HIV 1 (0.5%) 2 (0.8%) 1.00
Chronic pulmonary disease 1 (0.5%) 0 (0%) 0.44
Bleeding 13 (6.4%) 28 (11%) 0.10
Fever 115 (57%) 145 (56%) 0.85
Diarrhoea 62 (31%) 101 (39%) 0.06
Shock 1 (0.5%) 1 (0.4%) 1.00
Confusion 0 (0%) 1 (0.4%) 1.00
Ebola RDT – – 0.63
    Oraquick 1 (0.6%) 3 (1.4%) –
    Not done 170 (99%) 205 (99%) –
Result of GeneXpert PCR – – 0.34
    Positive 173 (99%) 213 (99%) –
    Negative 0 (0%) 2 (0.9%) –
    Indeterminate 1 (0.6%) 0 (0%) –
Ct (lowest) – – 0.62
    Median (Min, Max) 24 (13, 40) 24 (15, 42) –
Ct Below 23 73 (36%) 79 (30%) 0.20
Hypokaliemia 3 (1.5%) 8 (3.1%) 0.36
Hyperkaliemia 3 (1.5%) 5 (1.9%) 1.00
Renal impairment 18 (8.9%) 26 (10%) 0.68
Rhabdomyolysis 11 (5.4%) 8 (3.1%) 0.21
Severe hypoglycemia 2 (1.0%) 5 (1.9%) 0.47
Platelets (x10⁹/L) – – 0.84
    Median (Min, Max) 166 (142, 181) 153 (27, 385) –
Haemoglobin (g/L) – – 0.74
    Median (Min, Max) 12.45 (10.60, 14.00) 13.15 (9.00, 17.90) –
Calcium (mmol/L) US – – 0.90
    Median (Min, Max) 8.30 (4.00, 9.70) 8.25 (4.00, 10.40) –
Antibacterial treatment 173 (85%) 217 (83%) 0.61
Antimalarial treatment 160 (79%) 177 (68%) 0.01
Oral/orogastric fluids 38 (19%) 41 (16%) 0.40
Blood transfusion 2 (1.0%) 2 (0.8%) 1.00
Ebola experimental treatment at admission 89 (44%) 113 (43%) 0.93
Type of Ebola experimental treament at admission – – 0.29
    REGN3470-3471-3479 27 (13%) 24 (9.2%) –
    Remdesivir (GS-5734) 25 (12%) 34 (13%) –
    Zmapp 1 (0.5%) 7 (2.7%) –
    mAb114 34 (17%) 47 (18%) –
    None 116 (57%) 148 (57%) –
Ebola experimental treatment 162 (80%) 200 (77%) 0.46
Type of Ebola experimental treament – – 0.24
    REGN3470-3471-3479 54 (27%) 55 (21%) –
    Remdesivir (GS-5734) 57 (28%) 69 (27%) –
    Zmapp 7 (3.4%) 20 (7.7%) –
    mAb114 44 (22%) 56 (22%) –
    None 41 (20%) 60 (23%) –
Days from Treament Initiation – – 0.32
    Median (Min, Max) 4.0 (-361.0, 28.0) 5.0 (-6.0, 36.0) –
Delay from Treament – – 0.68
    Less than 3 days 40 (25%) 46 (23%) –
    3 to 5 days 45 (28%) 49 (25%) –
    More than 5 days 76 (47%) 102 (52%) –
Outcome at discharge – – 0.88
    Death 67 (33%) 83 (32%) –
    Full recovery with sequelae 0 (0%) 1 (0.4%) –
    Full recovery without sequelae 110 (54%) 147 (57%) –
    Referred to another facility 2 (1.0%) 1 (0.4%) –
    Unknown 24 (12%) 28 (11%) –
1 n (%)
2 Wilcoxon rank sum test; Pearson’s Chi-squared test; Fisher’s exact test
Population characteristics: Treatment Delay
Characteristic Less than 3 days
N = 861		 3 to 5 days
N = 941		 More than 5 days
N = 1781		 p-value2
Age at admission – – – 0.39
    Median (Min, Max) 31 (0, 62) 30 (0, 71) 32 (2, 70) –
Age Group – – – –
    <5 8 (10%) 1 (1.1%) 4 (2.3%) –
    5-17 3 (3.8%) 7 (7.6%) 22 (13%) –
    18-24 18 (23%) 17 (18%) 35 (20%) –
    25-34 25 (31%) 33 (36%) 34 (19%) –
    35-49 18 (23%) 25 (27%) 55 (31%) –
    50+ 8 (10%) 9 (9.8%) 26 (15%) –
Gender – – – 0.68
    Male 40 (47%) 45 (48%) 76 (43%) –
    Female 46 (53%) 49 (52%) 102 (57%) –
Patient occupation – – – 0.00
    Healthcare worker 14 (32%) 13 (22%) 11 (11%) –
    Non-healthcare worker 14 (32%) 16 (27%) 50 (51%) –
    Unknown 16 (36%) 31 (52%) 38 (38%) –
Is the patient pregnant? 3 (3.5%) 2 (2.1%) 7 (3.9%) 0.81
Admission Delay – – – 0.00
    Median (Min, Max) 1.0 (0.0, 2.0) 3.0 (0.0, 4.0) 6.0 (1.0, 39.0) –
Does the patient have any comorbid conditions? 1 (1.2%) 2 (2.1%) 3 (1.7%) 1.00
Diabetes 0 (0%) 0 (0%) 1 (0.6%) 1.00
HIV 0 (0%) 2 (2.1%) 0 (0%) 0.13
Chronic pulmonary disease 0 (0%) 0 (0%) 1 (0.6%) 1.00
Bleeding 4 (4.7%) 5 (5.3%) 25 (14%) 0.01
Fever 55 (64%) 47 (50%) 103 (58%) 0.16
Diarrhoea 22 (26%) 33 (35%) 77 (43%) 0.02
Shock 0 (0%) 0 (0%) 2 (1.1%) 0.74
Confusion 0 (0%) 0 (0%) 1 (0.6%) 1.00
Ebola RDT – – – 0.81
    Oraquick 1 (1.3%) 0 (0%) 3 (2.2%) –
    Not done 75 (99%) 73 (100%) 136 (98%) –
Result of GeneXpert PCR – – – 1.00
    Positive 78 (100%) 76 (100%) 141 (99%) –
    Negative 0 (0%) 0 (0%) 1 (0.7%) –
    Indeterminate 0 (0%) 0 (0%) 0 (0%) –
Ct (lowest) – – – 0.02
    Median (Min, Max) 27 (13, 40) 23 (16, 38) 24 (15, 40) –
Ct Below 23 21 (24%) 34 (36%) 60 (34%) 0.20
Hypokaliemia 0 (0%) 4 (4.3%) 4 (2.2%) 0.14
Hyperkaliemia 2 (2.3%) 1 (1.1%) 4 (2.2%) 0.79
Renal impairment 6 (7.0%) 9 (9.6%) 24 (13%) 0.25
Rhabdomyolysis 2 (2.3%) 4 (4.3%) 12 (6.7%) 0.36
Severe hypoglycemia 0 (0%) 1 (1.1%) 2 (1.1%) 1.00
Platelets (x10⁹/L) – – – 0.29
    Median (Min, Max) 44 (30, 168) 122 (27, 318) 164 (61, 385) –
Haemoglobin (g/L) – – – 0.55
    Median (Min, Max) 13.40 (13.10, 14.00) 14.00 (12.00, 16.00) 12.90 (9.00, 17.90) –
Calcium (mmol/L) US – – – 0.77
    Median (Min, Max) 8.20 (4.00, 9.70) 7.90 (4.00, 9.40) 8.30 (4.00, 10.40) –
Antibacterial treatment 64 (74%) 82 (87%) 149 (84%) 0.06
Antimalarial treatment 54 (63%) 73 (78%) 126 (71%) 0.09
Oral/orogastric fluids 23 (27%) 12 (13%) 28 (16%) 0.03
Blood transfusion 2 (2.3%) 0 (0%) 1 (0.6%) 0.21
Type of Ebola experimental treament – – – –
    REGN3470-3471-3479 27 (31%) 29 (31%) 52 (29%) –
    Remdesivir (GS-5734) 22 (26%) 42 (45%) 61 (34%) –
    Zmapp 4 (4.7%) 3 (3.2%) 20 (11%) –
    mAb114 33 (38%) 20 (21%) 45 (25%) –
    None 0 (0%) 0 (0%) 0 (0%) –
Days from Treament Initiation – – – 0.00
    Median (Min, Max) 2.0 (-361.0, 2.0) 3.0 (3.0, 4.0) 7.0 (5.0, 36.0) –
Outcome at discharge – – – 0.00
    Death 14 (16%) 34 (36%) 73 (41%) –
    Full recovery with sequelae 0 (0%) 0 (0%) 1 (0.6%) –
    Full recovery without sequelae 65 (76%) 47 (50%) 90 (51%) –
    Referred to another facility 0 (0%) 1 (1.1%) 1 (0.6%) –
    Unknown 7 (8.1%) 12 (13%) 13 (7.3%) –
1 n (%)
2 Kruskal-Wallis rank sum test; NA; Pearson’s Chi-squared test; Fisher’s exact test
Population characteristics: Ct at admission
Characteristic Above 23
N = 2011		 Below 23
N = 1521		 p-value2
adult_child – – 0.55
    Adult 172 (88%) 124 (86%) –
    Children (<18) 24 (12%) 21 (14%) –
Age at admission – – 0.23
    Median (Min, Max) 32 (0, 70) 30 (2, 66) –
Age Group – – 0.17
    <5 10 (5.1%) 5 (3.4%) –
    5-17 14 (7.1%) 16 (11%) –
    18-24 43 (22%) 28 (19%) –
    25-34 43 (22%) 44 (30%) –
    35-49 53 (27%) 38 (26%) –
    50+ 33 (17%) 14 (9.7%) –
Gender – – 0.43
    Male 88 (44%) 73 (48%) –
    Female 113 (56%) 79 (52%) –
Patient occupation – – 0.47
    Healthcare worker 17 (14%) 12 (13%) –
    Non-healthcare worker 68 (56%) 43 (48%) –
    Unknown 37 (30%) 34 (38%) –
Is the patient pregnant? 5 (2.5%) 7 (4.6%) 0.28
Admission Delay – – 0.00
    Median (Min, Max) 3.0 (0.0, 34.0) 5.0 (0.0, 33.0) –
Does the patient have any comorbid conditions? 2 (1.0%) 4 (2.6%) 0.41
Diabetes 0 (0%) 1 (0.7%) 0.43
HIV 0 (0%) 2 (1.3%) 0.18
Chronic pulmonary disease 0 (0%) 1 (0.7%) 0.43
Bleeding 13 (6.5%) 23 (15%) 0.01
Fever 110 (55%) 92 (61%) 0.28
Diarrhoea 60 (30%) 69 (45%) 0.00
Shock 0 (0%) 2 (1.3%) 0.18
Confusion 1 (0.5%) 0 (0%) 1.00
Ebola RDT – – 1.00
    Oraquick 2 (1.0%) 2 (1.4%) –
    Not done 189 (99%) 145 (99%) –
Result of GeneXpert PCR – – 1.00
    Positive 201 (100%) 152 (100%) –
    Negative 0 (0%) 0 (0%) –
    Indeterminate 0 (0%) 0 (0%) –
Ct (lowest) – – 0.00
    Median (Min, Max) 29 (23, 42) 20 (13, 23) –
Ct Below 23 0 (0%) 152 (100%) 0.00
Hypokaliemia 8 (4.0%) 3 (2.0%) 0.36
Hyperkaliemia 2 (1.0%) 6 (3.9%) 0.08
Renal impairment 18 (9.0%) 23 (15%) 0.07
Rhabdomyolysis 7 (3.5%) 12 (7.9%) 0.07
Severe hypoglycemia 3 (1.5%) 4 (2.6%) 0.47
Platelets (x10⁹/L) – – 0.09
    Median (Min, Max) 148 (27, 237) 216 (88, 385) –
Haemoglobin (g/L) – – 0.96
    Median (Min, Max) 13.10 (9.00, 17.90) 13.00 (10.10, 17.90) –
Calcium (mmol/L) US – – 0.00
    Median (Min, Max) 8.70 (4.00, 10.40) 7.80 (4.00, 9.90) –
Antibacterial treatment 176 (88%) 137 (90%) 0.45
Antimalarial treatment 162 (81%) 114 (75%) 0.21
Oral/orogastric fluids 35 (17%) 30 (20%) 0.58
Blood transfusion 0 (0%) 3 (2.0%) 0.08
Ebola experimental treatment at admission 87 (43%) 78 (51%) 0.13
Type of Ebola experimental treament at admission – – 0.01
    REGN3470-3471-3479 19 (9.5%) 29 (19%) –
    Remdesivir (GS-5734) 25 (12%) 25 (16%) –
    Zmapp 2 (1.0%) 5 (3.3%) –
    mAb114 41 (20%) 17 (11%) –
    None 114 (57%) 76 (50%) –
Ebola experimental treatment 156 (78%) 116 (76%) 0.77
Type of Ebola experimental treament – – 0.13
    REGN3470-3471-3479 42 (21%) 45 (30%) –
    Remdesivir (GS-5734) 53 (26%) 41 (27%) –
    Zmapp 10 (5.0%) 7 (4.6%) –
    mAb114 51 (25%) 23 (15%) –
    None 45 (22%) 36 (24%) –
Days from Treament Initiation – – 0.33
    Median (Min, Max) 4.0 (0.0, 36.0) 5.0 (-6.0, 28.0) –
Delay from Treament – – 0.13
    Less than 3 days 45 (29%) 21 (18%) –
    3 to 5 days 39 (25%) 34 (30%) –
    More than 5 days 71 (46%) 60 (52%) –
Outcome at discharge – – 0.00
    Death 29 (14%) 93 (61%) –
    Full recovery without sequelae 148 (74%) 41 (27%) –
    Referred to another facility 1 (0.5%) 2 (1.3%) –
    Unknown 23 (11%) 16 (11%) –
1 n (%)
2 Pearson’s Chi-squared test; Wilcoxon rank sum test; Fisher’s exact test

Sampling

Cases Description

Patient Outcomes by Admission Delay

  • Deceased patients (n=147) had a median admission delay of 5 days (IQR 4.5, range 0-39)
  • Recovered patients (n=253) had a median admission delay of 3 days (IQR 4, range 0-32)

Ct kinetics

  • A linear mixed-effects model with random intercepts per participant showed that Ct values significantly increased over time (β = 0.25, p < 0.001), consistent with viral load decline.
  • Participants who died had markedly lower baseline Ct values compared to recovered individuals (β = −8.65, p < 0.001), indicating higher initial viral loads.
  • The interaction between time and outcome was not significant (p = 0.60), suggesting similar Ct kinetics across outcomes.

\[ Ct_{ij} = \beta_0 + \beta_1 (\text{Time from Onset}_{ij}) + \beta_2 (\text{Outcome}_i) + \beta_3 (\text{Time from Onset} \times \text{Outcome}_i) + u_i + \epsilon_{ij} \]

  • (Ct_{ij}): Ct value for participant i at time j
  • (_0): intercept (baseline Ct for recovered)
  • (_1): daily Ct change among recovered
  • (_2): baseline difference (Death vs Recovered)
  • (_3): interaction (difference in Ct trajectory)
  • (u_i): random intercept
  • (_{ij}): residual error

Cases and CFR

Treatments and complications

These complications are inferred from laboratory results :

  • Renal impairment: Creatinine (mg/dL)≥1.1
  • Hyperkaliemia: Potassium (mmol/L)>5.5
  • Hypokaliemia: Potassium (mmol/L)<3.5
  • Rhabdomyolysis: Creatinine kinase (U/L)>1000
  • Severe hypoglycemia: Glucose (mg/dL) <60
  • Severe thrombocytopenia: Platelets (x10⁹/L) <50

Analyses

Approach

flow ImmuneMod Immune modulation DelDirect Deleterious direct effect of virus ImmuneMod->DelDirect +/- ViralLoad Viral load ViralLoad->DelDirect + OrganFail Organ failure DelDirect->OrganFail + Death Death OrganFail->Death + PreExist Pre-existing comorbidity PreExist->OrganFail + Age Age Age->PreExist +/- Sex Sex Sex->PreExist DelayedPres Delayed presentation Sex->DelayedPres Nutrition Nutrition Nutrition->PreExist + DelayedPres->ViralLoad + Vaccination Vaccination Vaccination->ViralLoad - Antiviral Antiviral therapy Antiviral->ViralLoad - Hypoperf Hypoperfusion / shock Hypoperf->OrganFail + Dehydration Dehydration Dehydration->Hypoperf + MetElect Metabolic / electrolyte derangement Dehydration->MetElect + MetElect->OrganFail + Hypoxa Hypoxaemia Hypoxa->OrganFail + Anemia Anaemia Anemia->Hypoxa + SecInf Secondary infection SecInf->OrganFail + SecInf->Hypoxa + Bleeding Bleeding Bleeding->Anemia + ORS ORS ORS->Dehydration - IVfluid IV fluid IVfluid->Dehydration - IVfluid->MetElect - Diarrhoea Diarrhoea Diarrhoea->Dehydration +
  • This Directed Acyclic Graphs (DAG) illustrates hypothesized causal relationships underlying EVD pathophysiology and clinical outcomes.
workflow A 1. Data cleaning and wrangling B 2. Univariate model screening • Identify sparse variables • Exclude predictors causing quasi-complete separation A->B C 3. Collinearity assessment • Variance Inflation Factor (VIF) • GVIF_scaled ≤ 1.68 B->C D 4. LASSO regression • Shrinks weak predictors • Retains strongest associations C->D E 5. Multivariable logistic regression • Include LASSO-selected predictors D->E F OR from multivariable model E->F G Adjusted RR (Poisson) E->G H Raw RR for binary predictors E->H

Ct threshold to predict participant outcome

  • ROC analyses were performed to determine the optimal Ct threshold to predict participant outcome.
  • With an area under the curve (AUC) of 0.85, ROC analyses evaluated the optimal Ct threshold cut-off at 23.25 for predicting patients outcome (sensitivity 79%, specificity 77%).

Independent Predictors of EVD Outcome and Complications

  • Multivariable Poisson regression with robust standard errors was used to estimate adjusted risk ratios (aRR) and 95% confidence intervals.
Symptom Grouping Used for Analysis
Category Variables
CNS signs agitation_anytime, coma_p_u_in_avpu_scoring, coma, desorientation_anytime, seizure_anytime, headache_anytime, irritability_confusion_anytime
Bleeding signs unusual_bleeding_bruising_anytime, bleeding
Gastrointestinal signs diarrhoea_anytime, nausea_vomiting_anytime, abdominal_pain_anytime, anorexia_anytime, dysphagia_anytime
Renal signs renal_impairment, anuria_anytime
Dehydration signs anuria_anytime, signs_of_dehydration_anytime
  • Note: Symptom grouping aimed to increase model power and interpretability by reducing sparse variables and capturing clinically coherent syndromic patterns.
Variable Relative Risk (95% CI) Direction
CT at Admission 0.86 (0.84-0.89) ⬇
Admission Delay 1.03 (1.01-1.04) ⬆
Remdesivir (GS-5734) 1.47 (1.1-1.96) ⬆
Zmapp 1.19 (0.78-1.8) ↔︎
mAb114 1.03 (0.72-1.49) ↔︎
None 1.16 (0.81-1.66) ↔︎
Bleeding Signs 1.27 (1.03-1.57) ⬆
Signs of Renal Impairment 1.07 (0.78-1.48) ↔︎
Rhabdomyolysis 1.14 (0.8-1.62) ↔︎
Variable Relative Risk (95% CI) Direction
CT at Admission 0.86 (0.83-0.89) ⬇
Treatment Delay (days) 1.03 (1.01-1.05) ⬆
Remdesivir (GS-5734) 1.47 (1.11-1.95) ⬆
Zmapp 1.3 (0.87-1.93) ↔︎
mAb114 1.03 (0.72-1.48) ↔︎
Pregnancy 0.69 (0.28-1.68) ↔︎
Bleeding Signs 1.3 (1.03-1.63) ⬆
Rhabdomyolysis 1.17 (0.83-1.65) ↔︎
  • Here we included only patients who received any Ebola experimental treatment to assess the specific impact of treatment delay.
Variable Relative Risk (95% CI) Direction
Age 5-17 0.19 (0.02-1.5) ↔︎
Age 35-49 1.34 (0.81-2.24) ↔︎
Pregnancy 1.86 (0.82-4.2) ↔︎
CT at Admission 0.95 (0.91-1) ⬇
mAb114 0.6 (0.29-1.24) ↔︎
Hyperkaliemia 1.93 (0.46-8.11) ↔︎
Hypokaliemia 5.24 (2.45-11.2) ⬆
Bleeding Signs 0.51 (0.28-0.9) ⬇
Signs of Dehydratation 3.21 (1.79-5.76) ⬆
Rhabdomyolysis 3.91 (2.02-7.57) ⬆
Severe Hypoglycemia 1.85 (0.37-9.16) ↔︎
Variable Relative Risk (95% CI) Direction
Age 25-34 1.39 (1.01-1.91) ⬆
Age 50+ 0.81 (0.45-1.46) ↔︎
CT at Admission 0.94 (0.92-0.97) ⬇
GastroIntestinal Signs 1.91 (0.74-4.92) ↔︎
Signs of Renal Impairment 0.6 (0.37-0.97) ⬇
Signs of Dehydratation 1.86 (1.33-2.59) ⬆

Logistic Regression of Factors Associated with Death and Complications

Final LASSO-Selected Logistic Regression: EVD Outcome
Multivariable model including LASSO-selected predictors
Characteristic N Event N OR 95% CI p-value Significance1 Direction Unadjusted RR2 Adjusted Risk Ratio (95% CI)3
CT at admission 358 134 0.74 0.69, 0.79 <0.001 *** ⬇
0.86 (0.84-0.89)
Delay from Onset to Admission 358 134 1.15 1.07, 1.25 <0.001 *** ⬆
1.03 (1.01-1.04)
Remdesivir 358 134 2.96 1.39, 6.49 0.006 ** ⬆
1.47 (1.1-1.96)
Zmapp 358 134 2.16 0.58, 8.27 0.25 ⬆
1.19 (0.78-1.8)
MAb114 358 134 1.09 0.45, 2.63 0.85 ⬆
1.03 (0.72-1.49)
No Treatments 358 134 1.47 0.64, 3.39 0.36 ⬆
1.16 (0.81-1.66)
Bleeding Signs 358 134 1.73 0.95, 3.15 0.073 . ⬆ 1.90 1.27 (1.03-1.57)
Signs of Renal Impairment 358 134 0.99 0.44, 2.21 0.98 ⬇ 1.45 1.07 (0.78-1.48)
Rhabdomyolysis 358 134 1.46 0.43, 5.51 0.56 ⬆ 1.92 1.14 (0.8-1.62)
Abbreviations: CI = Confidence Interval, OR = Odds Ratio, NA
1 Odds ratios (OR) obtained by exponentiating the logistic regression coefficients (β). OR > 1 indicates increased odds of the outcome; OR < 1 indicates decreased odds.
2 Raw risk ratios (RR) were calculated as the ratio of the risk of death among participants with the condition (Yes) versus without the condition (No).
3 Adjusted risk ratios (RR) obtained from Poisson regression with robust standard errors. RR > 1 indicates increased risk; RR < 1 indicates decreased risk.
  • For each 1 Ct increase at admission, the odds of death decreased by 29% (OR 0.71, 95% CI 0.65–0.77) and the risk of death decreased by 14% (RR 0.86).
  • For each day of delay at admission, the odds of death increased by 13% (OR 1.13, 95% CI 1.04–1.23) and the risk of death increases by 2% (RR 1.02).
  • Note: While the unadjusted risk of death was slightly higher in participants with dehydration, the multivariable model adjusting for other clinical factors indicated that dehydration was associated with lower risk of death (adjusted RR = 0.6), likely reflecting confounding factors.
Final LASSO-Selected Logistic Regression: EVD Outcome among Treated
Multivariable model including LASSO-selected predictors
Characteristic N Event N OR 95% CI p-value Significance1 Direction Unadjusted RR2 Adjusted Risk Ratio (95% CI)3
CT at admission 290 110 0.72 0.66, 0.78 <0.001 *** ⬇
0.86 (0.83-0.89)
Treatment Delay (days) 290 110 1.13 1.04, 1.23 0.005 ** ⬆
1.03 (1.01-1.05)
Remdesivir (GS-5734) 290 110 3.09 1.43, 6.97 0.005 ** ⬆
1.47 (1.11-1.95)
Zmapp 290 110 2.17 0.60, 8.25 0.24 ⬆
1.3 (0.87-1.93)
mAb114 290 110 1.15 0.47, 2.84 0.76 ⬆
1.03 (0.72-1.48)
Pregnancy 290 110 0.37 0.07, 1.66 0.21 ⬇ 0.65 0.69 (0.28-1.68)
Bleeding Signs 290 110 1.99 1.01, 3.96 0.048 * ⬆ 2.02 1.3 (1.03-1.63)
Rhabdomyolysis 290 110 1.53 0.46, 5.55 0.49 ⬆ 1.85 1.17 (0.83-1.65)
Abbreviations: CI = Confidence Interval, OR = Odds Ratio, NA
1 Odds ratios (OR) obtained by exponentiating the logistic regression coefficients (β). OR > 1 indicates increased odds of the outcome; OR < 1 indicates decreased odds.
2 Raw risk ratios (RR) were calculated as the ratio of the risk of death among participants with the condition (Yes) versus without the condition (No).
3 Adjusted risk ratios (RR) obtained from Poisson regression with robust standard errors. RR > 1 indicates increased risk; RR < 1 indicates decreased risk.
  • Here we included only patients who received any Ebola experimental treatment to assess the specific impact of treatment delay.
Final LASSO-Selected Logistic Regression: Renal Impairment
Multivariable model including LASSO-selected predictors
Characteristic N Event N OR 95% CI p-value Significance1 Direction Unadjusted RR2 Adjusted Risk Ratio (95% CI)3
Age 5-17 358 49 0.04 0.00, 0.42 0.024 * ⬇
0.19 (0.02-1.5)
Age 35-49 358 49 1.64 0.71, 3.72 0.24 ⬆
1.34 (0.81-2.24)
Pregnancy 358 49 2.26 0.49, 9.12 0.27 ⬆ 1.90 1.86 (0.82-4.2)
CT at admission 358 49 0.93 0.86, 0.99 0.037 * ⬇
0.95 (0.91-1)
MAb114 358 49 0.46 0.11, 1.44 0.22 ⬇
0.6 (0.29-1.24)
hyperkaliemia 358 49 44.2 3.98, 717 0.003 ** ⬆ 5.70 1.93 (0.46-8.11)
hypokaliemia 358 49 11.3 2.22, 55.3 0.002 ** ⬆ 3.09 5.24 (2.45-11.2)
Bleeding Signs 358 49 0.33 0.12, 0.82 0.022 * ⬇ 0.85 0.51 (0.28-0.9)
Signs of Dehydratation 358 49 10.0 4.04, 25.8 <0.001 *** ⬆ 4.35 3.21 (1.79-5.76)
Rhabdomyolysis 358 49 35.7 9.90, 156 <0.001 *** ⬆ 7.14 3.91 (2.02-7.57)
Severe Hypoglycemia anytime 358 49 13.4 1.31, 140 0.022 * ⬆ 5.21 1.85 (0.37-9.16)
Abbreviations: CI = Confidence Interval, OR = Odds Ratio, NA
1 Odds ratios (OR) obtained by exponentiating the logistic regression coefficients (β). OR > 1 indicates increased odds of the outcome; OR < 1 indicates decreased odds.
2 Raw risk ratios (RR) were calculated as the ratio of the risk of death among participants with the condition (Yes) versus without the condition (No).
3 Adjusted risk ratios (RR) obtained from Poisson regression with robust standard errors. RR > 1 indicates increased risk; RR < 1 indicates decreased risk.
  • Patients with renal impairment had substantially higher odds of developing hyperkalemia compared to those with normal renal function. However, the confidence interval is wide, reflecting the small number of hyperkalemia events.
Final LASSO-Selected Logistic Regression: Bleeding
Multivariable model including LASSO-selected predictors
Characteristic N Event N OR 95% CI p-value Significance1 Direction Unadjusted RR2 Adjusted Risk Ratio (95% CI)3
Age 25-34 358 107 1.71 0.99, 2.95 0.052 . ⬆
1.39 (1.01-1.91)
Age 50+ 358 107 0.74 0.31, 1.62 0.46 ⬇
0.81 (0.45-1.46)
CT at admission 358 107 0.92 0.88, 0.96 <0.001 *** ⬇
0.94 (0.92-0.97)
GastroIntestinal Signs 358 107 2.25 0.81, 7.98 0.16 ⬆ 2.70 1.91 (0.74-4.92)
Signs of Renal Impairment 358 107 0.42 0.19, 0.90 0.031 * ⬇ 0.87 0.6 (0.37-0.97)
Signs of Dehydratation 358 107 3.19 1.59, 6.58 0.001 ** ⬆ 2.02 1.86 (1.33-2.59)
Abbreviations: CI = Confidence Interval, OR = Odds Ratio, NA
1 Odds ratios (OR) obtained by exponentiating the logistic regression coefficients (β). OR > 1 indicates increased odds of the outcome; OR < 1 indicates decreased odds.
2 Raw risk ratios (RR) were calculated as the ratio of the risk of death among participants with the condition (Yes) versus without the condition (No).
3 Adjusted risk ratios (RR) obtained from Poisson regression with robust standard errors. RR > 1 indicates increased risk; RR < 1 indicates decreased risk.

Survival Analyses

  • We used a Weibull proportional hazards model to estimate survival probabilities over time.

  • Forest plot showing relative effects of covariates on survival time estimated from a Weibull proportional hazards model. HR > 1 indicates shorter survival (faster occurrence of the event), HR < 1 indicates longer survival. Error bars represent 95% confidence intervals.

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